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General NPI Number Information
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NPI Number | 1982031464
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Entity Type | Organization
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Legal Business Name | FLORIDA PAIN & REHABILITATION INSTITUTE INC
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Dates
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Enumeration Date | 09/30/2013
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Last Update Date | 09/20/2016
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Provider Practice Location Address
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Address Line | 440 SW PERIMETER GLN
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City | LAKE CITY
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State | FL
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Zip | 32025-0497
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Country | US
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Telephone | 386-719-9663
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Fax | 866-300-2394
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Provider Business Mailing Address
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Address Line | 5365 W ATLANTIC AVE SUITE 504
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City | DELRAY BEACH
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State | FL
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Zip | 33484-8172
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Country | US
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Telephone | 561-241-9300
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Fax | 561-241-9339
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Authorized Official
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Title or Position | OWNER
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Name | CHERIAN K. SAJAN
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Credential | MD
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Telephone | 407-622-5766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | ME109651
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | ME109651
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | ME109651
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License Number State | FL
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